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In the restoration of severely mutilated vital teeth requiring cuspal coverage, pin retained amalgam and composite restorations were studied as long term alternatives to cast restorations. Since pins have some inherent disadvantages, glass ionomer-composite bilayered restorations were also studied as alternatives for cusp buildups. The study concluded that bilayered restorations exhibited the maximum fracture resistance, followed by pin retained composite. Pin retained amalgam showed the least fracture resistance. All the three materials/techniques behaved satisfactorily as regards the clinical performance over a period of nine months.